A Case of Non-Occlusive Mesenteric Ischemia with Hepatic Portal Venous Gas Successfully Treated by Continuous Intra-Arterial Infusion Therapy

Abstract

An 85-year-old man, treated nine days earlier by transcatheter arterial embolization for a ruptured hepatocellular carcinoma, presented to us complaining of abdominal pain and went into shock. Based on the findings of abdominal contrast-enhanced CT, we suspected nonocclusive mesenteric ischemia（NOMI） and performed angiography for confirmation and intervention. The angiography revealed neither vasospasm nor any other obstructive findings. Nonetheless, we diagnosed the patient as having NOMI and immediately started him on intra-arterial papaverine infusion therapy. Eight days after the start of this therapy, the patient showed significant recovery and was transferred from the ICU to the ward. Thus, continuous intra-arterial papaverine infusion therapy appears to be beneficial for NOMI patients who do not exhibit the typical angiographic findings.